Transcript

Speaker 1 (00:04):
Coming to you from Beaumont, this is your HouseCall.
Jean Cummings (00:14):
My name's Jean. I am an alcoholic. I have been sober since, June 11th, 1997, was my last drink. I grew up, perfect normal little family that people have that image of, right? However, I grew up seeing people drink every day.
When I first started drinking, I was young. I was 13, and alcohol became a problem for me immediately. I was a runaway by the age of 15. My mom started trying to control me and telling me what to do. I don't like to be told what to do. I haven't met many alcoholics that do. I dropped out of high school. I was a problem child. Nobody knew what to do with me. I remember a therapist told me, they said, "Jean, you're not the problem. Your parents are. Your parents are alcoholic." And I'm like, "Okay, what do I do?" And she said, "Go back to school, get your high school diploma, and then you can do whatever you want with your life. You can live your life any way you want." I'm like, "Okay."
Got my high school diploma. And, the day I graduated, I pretty much moved out. I was gone. I consumed alcohol on a regular basis. I was drinking about a fifth every other day. I was eating baloney sandwiches and popcorn just to survive. And I was working three jobs just so I could drink. That was my existence for quite some time.
I never equated, the alcohol was the problem in my life. I always blamed everybody else for all the problems that were happening in my life. Even though I had enough evidence in front of me to say, "This might be a problem for you," the solution was never to quit drinking. It was always to find another solution. I was a habitual drunk driver. My last drunk driving, I was looking at many felonies. I was looking at prison time. My friend bailed me out of jail. He says, "What are you going to do?" I says, "Let's go to the bar and think about it," because that was the solution to all my problems.
Everything was unraveling, and I couldn't control it. I couldn't reel it in at all. And I had friends and people that were sober. And, I called them. I said, "What do I do?" They said, "Go to a meeting." That was my aha moment. And my life changed at that point. I know the loneliness of this disease. I know the isolation of it. I know the lies that come along with it. I didn't know there was another way to live my life until I came in and somebody said, "Hey, try this. Let's see if this works for you." And it was putting the drink down and trying a different way to live my life. And I did that.
I have yet to pick up a drink. My experience was, I didn't have to go back out to prove I was an alcoholic. I knew I was an alcoholic. Today, the drink is no longer the problem for me. I don't have ... That problem has been removed from me. I am, I consider myself recovered.
Dr. Ahsa Shajahan (02:52):
You've just heard from Jean Cummings, a recovered alcoholic, who's coached many people through alcoholism. And, that's exactly what we're going to talk about.
Hello, and welcome to the Beaumont HouseCall podcast. I'm Dr. Ahsa Shajahan. Our goal is to help you and your family live smarter and healthier lives. Today, we're talking about alcoholism. I've seen so many people struggling with alcohol since the pandemic started. I'm consistently seeing people that are finding it harder and harder to stop. So, joining us today is Dr. Jeffrey Guina, the program director of psychiatry at Beaumont Health, and the chief medical officer at Easter Seals. Dr. Guina, thank you so much for being with us today.
Dr. Jeffrey Guina (03:38):
Sure. Thank you for having me.
Dr. Ahsa Shajahan (03:39):
I've been seen so much alcoholism in my clinic, much more than ever before. I think maybe I might have had one or two in my practice that I was aware of. And probably in the last year, the number of people that are reporting alcohol use has risen significantly, just personally in my own practice. And, I know that looking at the data in the United States, it seems like people are drinking a lot more. There's a lot more heavy drinking and then there's a lot more alcoholism. I think it was reported that, there was about a 21% increase during the pandemic of excessive drinking, such as binge drinking. What have you been seeing?
Dr. Jeffrey Guina (04:19):
It's been a huge problem. Both drugs and alcohol have spiked. In fact, last week I read an article that said more people under the age of 65 have died from alcohol related deaths, than died from COVID during the pandemic. And that's a huge from pre-COVID times. I think there's a lot of factors that are going on. We know that when stress is high, that people are more likely to turn to drugs and alcohol. We know that when there's economic problems, particularly unemployment, that there's also an increase in suicides, and drug and alcohol related deaths. And so, I think during COVID, there's been a lot of direct and indirect effects, that have affected mental health and substance use disorders.
So, of course, the actual stress and fear related to the virus itself, grief and loss, but then also more the indirect effects that are more related to shutdowns, and people losing their jobs, people losing their businesses, people being isolated, people being at home. Sometimes being at home could be welcomed, sometimes being at home, just because of the normal stresses of family, or because maybe the people you live with are abusive or violent. You're kind of trapped with them. So for all those reasons, I think people are trying to cope the best they can. And unfortunately, sometimes when they're stressed, the turning to alcohol, whether it's a new thing for someone or whether it's, they used to have a problem with alcohol and they've been able to recover, and now they're relapsing because of the stress.
Dr. Ahsa Shajahan (06:16):
Yeah. It sounds like it's just the perfect storm for something awful, I think, if you don't have healthy coping mechanisms when you're stressed. When you're stressed and you say, "I need to grab for a drink and that's going to make me feel better," that's always not a good sign. Because we want healthy coping mechanisms, because otherwise, some people turn to food, some people turn to alcohol, some people turn to risky behaviors, and those are things that are just going to bring you more trouble over time. And I think what the thing about alcoholism, a lot of people don't realize, is that how much it affects your liver. I think there was a report that said, that was 8,000 additional deaths from alcohol related to liver disease. So, your damaging your liver. And that's why a lot of people end up dying, not so much from withdrawal of alcohol. It's more so from the related consequences that the alcohol does to your body.
Dr. Jeffrey Guina (07:09):
Kind of the way I think about coping skills is that, we all have this list in our minds and it may be conscious, or semi-conscious, or totally unconscious, but we have a list of go-to things we do when we're stressed. And when number one fails us, we go to number two. And when that fails us, and we go to number three. And on all of our lists, somewhere on all of our lists is drugs, alcohol, suicide. It might be number a thousand on your list, but it might be number three on my list. And when stress is higher, we tend to go down our list more. And there's healthy and unhealthy coping skills on all of our lists. But the more stressed we are, the more likely we are to burn through those healthy coping skills to get to those unhealthy coping skills. And then the other issue with the pandemic and the shutdowns, is some of our healthy coping skills have been limited to us.
Dr. Ahsa Shajahan (08:09):
Yeah, absolutely.
Dr. Jeffrey Guina (08:09):
So, going to the gym, going to church, mosque, synagogue, going out with friends, going and visiting your grandparent or parent at the nursing home. Those kinds of things that we did, sports, all sorts of things that have been limited to us. So when those things are closed, but liquor stores, casinos, marijuana dispensaries are open, we turn to what's available to us to cope.
Dr. Ahsa Shajahan (08:38):
Yeah. I think they said something like, there was a 54% increase in the sales of alcohol during COVID. But, what I wanted to talk about is that, people are like, "Yeah." They might be listening and thinking, "Yeah, I just have one or two drinks. It's not really a problem. I might have during the week." Can you define what heavy drinking is, and what alcoholism is, or having a problem? Because, I think, a lot of people don't realize that they may have a problem.
Dr. Jeffrey Guina (09:07):
One of the important things about substance use disorders is that there's no certain amount that determines that, "Ah, you have alcohol use disorder, because you drink above this many drinks a week, and you don't because you don't." But as far as at risk drinking, drinking that puts someone at risk of eventually developing a problem, but that doesn't necessarily mean they do or that they ever will, we just generally say above seven drinks a week for women, and above 14 drinks a week for men is when we really start having concerns. People who drink less than that certainly have problems, and people who drink more than that sometimes, don't have problems. That's one of the kind of benchmarks that's out there.
Dr. Ahsa Shajahan (09:55):
That's like one drink a day, a week, or two drinks a day for a gentleman versus a female. I'm also thinking though, what about the ability to stop? Because I know there are people that are like, "I don't really need a drink today," but then they still have one anyway. And one of the tips that Jean was telling me, was that if you are drinking every day and you can't stop. So you tell yourself, "I'm just not going to drink for two weeks." And then you find that a week and a half in, you're already drinking again, that you might be starting to have a problem. What do you think about that?
Dr. Jeffrey Guina (10:30):
That would be evidence of having withdrawal, which would indicate that you have a physiologic dependence to alcohol. But when we say problem again, when I'm looking at whether someone has a substance use disorder, I'm not necessarily looking at the amounts. I might screen with the amount to try to get a sense of what's going on. But what I'm really looking for is when we talk about abuse, we usually look at four things, that someone's drinking despite having one of one or more of these four problems. So the pneumonic is the four LS, livers, lovers, livelihood, and legal. And so livers means, you're drinking despite the medical problem that the alcohol is causing. You know you have hepatitis, you know you have ...
Dr. Ahsa Shajahan (11:23):
Elevated liver enzymes or?
Dr. Jeffrey Guina (11:25):
Or, it's causing you injuries. You've fallen because of it. You got in a car accident because of it. So, it's causing you physical problems, yet you're continuing to use, even though you know it's connected to problems. Then there's lovers, so it's causing relationship problems. It might be romantic relationships. It might be friendships, but you're having problems and you continue to drink, even though it's causing these problems. Livelihood, it's affecting your work or maybe your school, and you continue to drink. You're showing up late to work. You're showing up drunk, you've been suspended, you're getting in fights at work, those sorts of things. And then legal, you continue to drink despite DUIs, MIPs, or if it's illegal drugs, those sorts of things. So those would be one example where we're thinking this is a problem, because it's causing problems in your life, and you continue to drink despite those problems.
Dr. Ahsa Shajahan (12:28):
Yeah. I think that's a good indication that definitely you have a problem at this point. But I guess what I'm trying to get at is, there's a lot of people that I'm seeing that are doing the heavy drinking, that are maybe not quite at that point. And it's like, how do you intervene before it gets to that point? Any tips there?
Dr. Jeffrey Guina (12:45):
It's a very difficult conversation to have. Studies suggests that 97% of people with substance use disorders don't think they have a problem.
Dr. Ahsa Shajahan (12:54):
Yeah. Denial's a big thing.
Dr. Jeffrey Guina (12:56):
Absolutely. Denial, normalization, which might be cultural, or might be in their family, or might be among their friends. It's like, "Everybody drinks like this," right?
Dr. Ahsa Shajahan (13:04):
Yeah. In our culture, we celebrate with alcohol. It's like, you go for a drink after work. Yeah. It's very common. Yeah.
Dr. Jeffrey Guina (13:11):
Sure. And, most people who drink alcohol don't have a problem. And that's part of the reason this is a hard conversation to have, because when you talk about prevention, someone might say, "I don't have a problem." And we might say, "Yeah." And they might say, "Well, I've been drinking like this for years, decades." And they may never develop a problem. So, it is hard. It's a sensitive conversation. It's hard. And I think education can be helpful, but also sometimes the way we might educate may lead someone to be very resistant or very defensive. And so, I think the most important tact we can take as clinicians, or as friends or family members of people that we're concerned about, is trying to listen and understand, and trying to ask rather than tell. And to really lower those defenses, and make sure that it's clear, that we're coming from a place of caring instead of judging.
Dr. Ahsa Shajahan (14:14):
Yeah. I like that. Ask rather than tell, because a lot of times you just want to say, "Stop drinking," or, "Maybe you're drinking too much," but maybe asking more about, "How do you feel," or, "What are the reasons why?" A lot of times with my patients, that people have gained a lot of weight during the pandemic and they'll say they're drinking more. And so, sometimes I'll go down the route of, "Do you feel healthy when you're drinking?" And talk about it from that angle.
So let's pretend. Okay, so we're talking now we sort of identified like when, what it would look like if you might have a problem. So what, and kind of, we talked a little bit about what friends and families can sort of do, but what are some of the treatments? So let's say you've realized it's time to seek help, or people are telling you that it's time to seek help. What are the treatments that are available, and what are the success rates of those treatments?
Dr. Jeffrey Guina (15:05):
The best way to treat any substance use disorder is comprehensively. There's usually not one magic bullet that will solve all problems, and there's different strokes for different folks. Some things are going to work for some people, and some things aren't going to work for others. Or, sometimes it's all about timing. There's people who've been in rehab facilities 10, 20, 50 times before they finally enter recovery. And maybe it's just a combination of factors. They needed a certain time in their life or things got really bad, or maybe it was just the right clinician that they had. All sorts of different things that happen. But I always like to say, I try to throw as many solutions at a problem as possible, and I try to see what sticks, and I try to give as many options as possible to the people I'm caring for.
So, first and foremost, I think the important thing is some sort of support, whether that's psychotherapy, one on one with a trained therapist or a group therapy. Or, is it a support group, like a 12-step program, or there's lots of other different kinds of recovery programs. And, this is also something that a lot of times people say, "Oh, I did AA once, and I don't like it." Well, there's a lot of different AA groups out there, and different people, and different philosophies. And just because you didn't mesh well with one, doesn't mean you might not with another. And there's other kinds of support groups besides AA, too. But we know that people who go through all 12 steps have very, very high success rate. It's just a lot of people don't go through the steps. They don't work it the way it's really designed to be, or they don't do it with a sponsor, those sorts of things.
Dr. Ahsa Shajahan (17:06):
Because, it sounds difficult, and you need a lot of support and you need a lot of motivation. And if you don't have the right support or motivation, it's going to be difficult to go through those steps. And then people have a lot of shame. People have a lot of fear, people feel denial, and I think those are all barriers to being successful. So you're saying that it's first of all, get a therapist. Second of all, maybe enroll in some type of program that involves coaching or group therapy, a 12-step program. Let's say someone has been drinking heavily and they want to stop, but they stop and they start getting the withdrawal symptoms of tremors and feeling nauseated. Then what do they do?
Dr. Jeffrey Guina (17:49):
There's two kinds of withdrawal. There's complicated withdrawal and there's uncomplicated withdrawal. So complicated withdrawal is where we're worried about life, about someone's life, because you can die from alcohol withdrawal. And the big signs that we're concerned about there are alcohol withdrawal seizures, alcohol withdraw hallucinations, or hallucinosis, and alcohol withdraw delirium, which is commonly called delirium tremens or DTs. But a lot of people misuse that term. What delirium tremens means, people tend to focus on the tremors of it. But what it really means is, you are confused. You don't know where you are, or you don't know who you are.
Dr. Ahsa Shajahan (18:33):
So scary.
Dr. Jeffrey Guina (18:36):
And, your consciousness is kind of in and out, and you're alert, and then you're kind of stuporous, and people can't arouse you. Those sorts of things. And that's when we're really concerned about death. And, so if someone has a history of any of that in the past, if they have a history of a seizure disorder, even if it wasn't alcohol related, or if they're showing signs of that now, that's when we really think that people should be doing their withdraw in a facility, in a medical facility. So, going to an emergency room, or going to a rehabilitation center directly.
Dr. Ahsa Shajahan (19:14):
Or a detox program.
Dr. Jeffrey Guina (19:15):
Right. But sometimes that's easier said than done. Sometimes those are very difficult to find, or they're expensive, but often going to the nearest emergency room is the best place to start. Especially if you aren't aware of the resources that are out there.
Dr. Ahsa Shajahan (19:31):
What are your thoughts about recovery houses and people getting into recovery homes? So, let's say you detox, and instead of going home to where it's all the same environments and the same stressors, going somewhere else.
Dr. Jeffrey Guina (19:44):
At Beaumont, we have several programs at several of our hospitals, where we try not to just send people home after detox. Try to make sure that they have follow-up with outpatient care, or they have a residential facility to go to. There are group homes out there, but that is also sometimes difficult to get into, difficult to find. But, there's pros and cons to all of those things, and it really depends on the situation for each person. Sometimes, someone can't just be away from work, days, weeks on end. So you're trying to balance the risk of them losing their job, which might put them at higher risk of using drugs and alcohol, with, "We really need to take this seriously." And, really need to kind of change the environment, as you said, and figure out how to make sure there's as much support in their life as possible, and as little temptation in their life, especially in this early time, when the risk of relapse is so high.
Dr. Ahsa Shajahan (20:41):
It sounds just so frustrating. It's such a complex problem. And I really feel for people that are going through it. And for friends and family that are trying to support people, it can be really isolating. And that's why I'm so much about like, "Let's try to prevent it before it gets to that point," but I know that it's a delicate balance of people thinking they can handle it, and those that may not be able to.
Dr. Jeffrey Guina (21:04):
Right. I think the important thing with prevention, or with just kind of working, rolling with people who are in denial, is finding out what their goals are, and trying to align with their goal. Because maybe their goal isn't to quit drinking, but maybe their goal is to have a better marriage.
Dr. Ahsa Shajahan (21:26):
Yes. Okay.
Dr. Jeffrey Guina (21:28):
And, the alcohol is affecting their marriage. Or maybe their goal is to get promoted at work, and alcohol is affecting their work. Or maybe their goal is to not have an upset stomach every day, and be in pain, and maybe alcohol is related to that. And so trying to, rather than thrust our goals on people, which is really hard not to do as a clinician, especially when, in a family member, when it's so obvious to you that this is a problem. Focusing on what they're looking for, what their goal is, and maybe trying to figure out with the person, "Is this alcohol, is this drug impairing your ability to achieve your goals, and get the things you say you want? And if so, what do we do about that?"
And, that's one way we can really align with people and try to be on the same page. Because, if they're coming in and they're totally focused on losing weight, or having a better relationship, or not being in pain, and we're constantly talking about, "Well, you got to quit drugs, you got to quit alcohol, you got to do it with smoking." They're going to be like, "Why aren't you listening to me? That's not what I want."
Dr. Ahsa Shajahan (22:37):
Got it. Yeah. That was such an important point. I think aligning with people's goals is a fantastic way to kind of really dig deep at maybe even the reasons why people might be turning to alcohol. And as Jean was saying, a lot of people turn to drinking because they're in pain, they're suffering and they just want it to stop. Or they just feel like they need an out. And so, it could be just lifestyle coping mechanisms. And like we said, with the pandemic, it's been really hard. There's so many things going on in the world that is very hard. And so, it takes a lot of steps for people to really look into healthier coping mechanisms.
Can you name a couple of healthy coping mechanisms for people? So if you're super stressed, what are some things that people can do as opposed to reaching for a drink?
Dr. Jeffrey Guina (23:27):
I've heard the quote said before that, "Exercise is the most underutilized antidepressant, and food is the most over-utilized antidepressant." So, exercise is really a great coping skill that people can use, to help them be mentally and physically healthy. And, it actually increases your stress tolerance. It actually increases your pain tolerance. So, exercise is a really important coping skill and a good way to get out stress too, acutely.
Other coping skills are maybe social, is talking to a trusted friend or loved one, and trying to maybe do enjoyable activities together. Those sorts of things. Distraction. Distraction can be a double edged sword, but if we do too much distraction and too much escapism, then that can impair our functioning in the world. And sometimes, we're often using, people are often using drugs and alcohol as a distraction, or as a way to escape. But finding healthy things to distract from, maybe a mild amount of TV, house projects, crafts. But the important thing is too, it should be enjoyable. For some people, they love doing house projects and some people, this is like, "Oh, this is work."
Dr. Ahsa Shajahan (24:51):
It stresses them out. I'm getting my basement done right now. It's like a hot mess.
Dr. Jeffrey Guina (24:56):
So yeah, it's finding the right things for right people. Other important things, breathing. Breathing is a really important coping skill and there's, people can look it up. If they do an online search for Four Square Breathing. You breathe in for four seconds, you hold it for four seconds. You breathe out for four seconds, you hold it for four seconds, and you just do it over and over, and over and over. And it's amazing. It sounds so simple. And it sounds hokey, but you do that and physiologically and psychologically, your body calms down by doing that.
We talked about exercise, but on the other side is food and eating healthy. Not eating too much and not eating too little. And when people get stressed, depressed, anxious, some people eat too much. Some people eat too little, and neither are good. Both things are going to fuel the problem. But a lot of times what we turn to is just eating lots of carbs. And then we're missing nutrients and healthy fatty acids. And, things that are important for our body and our brain, fighting stress and fighting pain. And then finally, I would say sleep. Sleep is, I mean, how many people are getting eight hours of sleep every night?
Dr. Ahsa Shajahan (26:22):
Not me.
Dr. Jeffrey Guina (26:22):
Many people are getting too little or too much. And really, the human body, the human brain, we need eight hours in a dark quiet space. That means no cell phone flashing, no TVs flashing, no radios, because even people who say, "I need that to fall asleep." Well, it may, may help you fall asleep, but it's going to keep you from getting that deep restful sleep, those deep stage sleep. And that's what makes us feel refreshed in the morning and restored, and helps our pain go away, and helps be more, have a higher stress tolerance and all of those things. So, those things are a lot of things we can do to both cope and prevent stress, and turning to unhealthy coping skills.
Dr. Ahsa Shajahan (27:08):
I want to switch back a little bit to treatment. So, many people are looking to their doctors for prescriptions to help them to stop drinking. Are prescriptions the way to go? Or, I know you said it's different for every person, but just what are some of those that they potentially ask for, to help with the stop drinking?
Dr. Jeffrey Guina (27:26):
Medicine is definitely effective and definitely important, and I prescribe it to patients with substance use disorders all the time. The important part though, is it's got to be part of a comprehensive treatment plan. I rarely see people get better with medicine alone. So having that medicine, plus a therapist and, or a group therapy and, or a 12-step support program and, or peer support, those sorts of things.
But as far as the medicines that are effective for alcohol use disorder, naltrexone is a medicine that's also prescribed for opioid use disorders and for overeating. And so, what naltrexone does is it affects the reward center of our brain and helps decrease our cravings for unhealthy reward stimulants. So, sex, drugs, alcohol, food all stimulate our reward center. And so that's part of the reason this helps for a lot of different addictions. And then, there is acamprosate. Acamprosate is specific for people with alcohol use disorder. And what that does is, it helps stabilize some of the chemicals in our brain that cause withdrawal. So when alcohol is a neuro depressant, a neuro inhibitor, it depresses our brain. That's part of the reason it increases depression and suicidality, even though people sometimes drink to help their depression. It actually worsens that.
Dr. Ahsa Shajahan (29:13):
It's a depressant, yeah.
Dr. Jeffrey Guina (29:13):
Yeah. It's a depressant. And so, but when we have so much alcohol in our system for so long that's been depressing activity, our brain reacts by creating more stimulants, by creating more glutamate, is the big one in our brain. And then when you take away the alcohol and you have all this unopposed glutamate, that's what causes seizures, and hallucinations, and delirium. So, what acamprosate does is it helps kind of balance the inhibition and the stimulation in our brain. And so, the withdrawal isn't as severe, those cravings aren't as severe, those sorts of things. And then the third and final one is disulfiram, which is a medicine that is actually aversive therapy. In fact, it's the only aversive therapy I know of that's FDA approved. And so, this is a medicine you take every day, and if you drink, you're going to get very sick.
Dr. Ahsa Shajahan (30:15):
Makes you feel nauseated, right?
Dr. Jeffrey Guina (30:17):
Feel nauseated. You might get a rash. You're going to feel ill. This is a medicine that can be really helpful for some people as a deterrent, but it's also a dangerous medicine because sometimes people who have alcohol use disorder are kind of thrill seekers, and I've had people intentionally test it. You can actually die from the combination. So it important that it's the right patient and there's enough education. They understand what's going on. And also, that they don't use like alcohol-based mouthwash or alcohol-based after shave because that can also trigger the symptoms. But I have also seen this medication work wonders for people. Some people need those medicines that more reduce their cravings, or make the withdrawal a little less severe. Some people need that deterrent. Different strokes for different folks.
Dr. Ahsa Shajahan (31:12):
Yeah. Again, it sounds like such a complex problem. And I think it just, it needs a lot of focus. It needs a lot of attention. It needs a lot of patience. So, any last advice for anyone who might be struggling with alcohol, or someone that you might suspect has a problem? What kind of advice would you give people?
Dr. Jeffrey Guina (31:34):
I would say people use substances for a lot of different reasons. Some people may be, "Self-medicating," for depression, for anxiety. Trauma is a big risk factor for substance use disorders. In fact, 50% of people with substance use disorders also have PTSD.
Dr. Ahsa Shajahan (31:57):
Yeah. Or even grief. A lot of people who've lost family members and friends.
Dr. Jeffrey Guina (32:01):
Absolutely. And so just getting "clean" might not necessarily solve the problem. And that's why it's so important to not just try to go cold turkey, or not just seek medicine to try to fight this. Sometimes those things work, but the chance of going, "Cold turkey," when you just stop on your own with nothing, the risk of relapse is about 95% within a year. So the best thing you can do is make sure you have that support. You have the therapy, you have the medicine, you have that comprehensive treatment. But then you're also looking at the underlying drivers of the substance use and make sure you're getting support, whether it's medicine, therapy, whatever, for that depression, for that anxiety, for the trauma, for those sorts of things. Because, that's going to help you not need to turn to the drugs and alcohol as much, at least for those people who are using it to self medicate or cope with an underlying problem.
Dr. Ahsa Shajahan (33:06):
What's a go-to resource for someone that might feel like, "Yeah, maybe I have a problem."
Dr. Jeffrey Guina (33:12):
There's a great resource about that, for really all mental health concerns, including substance use disorders. The National Alliance of Mental Illness has a great website with a lot of different resources and handouts, that people are concerned about themselves, or their loved ones, or clinicians can go to. There's also the SAMHSA website.
Dr. Ahsa Shajahan (33:39):
Oh, yeah. I love that one. Yep.
Dr. Jeffrey Guina (33:40):
Yeah. S-A-M-H-S-A, and that's the Substance Abuse and Mental Health Services Administration. There's a lot of resources there.
Dr. Ahsa Shajahan (33:50):
SAMHSA is great. They've got all sorts of things at a very normal reading level. It's not like high tech medical. They've got support groups. They've got a podcast you can listen to, they got videos you can watch. They have definitions. I think that's one of my favorite resources. Thanks for sharing that one.
Dr. Jeffrey Guina (34:08):
Yeah. And then finally, I would just say locally, I work for Easter Seals and Eastersealsmichigan.com has free, anonymous screenings for, you can take one specific for drugs or alcohol, or you can take a more comprehensive one for depression, anxiety, substance use, all sorts of things. And at the end of those, there's a list of resources and those are totally anonymous. So, no one's going to-
Dr. Ahsa Shajahan (34:37):
So, it's an online, almost like a test. Online test that you can take to see like, "Ooh, maybe I'm in trouble."
Dr. Jeffrey Guina (34:45):
Yeah. And so, it's five to 10 minutes and you can take it or put information about a loved one in it to see if, are they showing these signs? And then at the end, there's resources locally and nationally that people can use. That's all on there free.
Dr. Ahsa Shajahan (35:02):
And then, Jean had also mentioned when we were talking, about the local police stations. Actually, I think in Macomb County and Oakland County, they do have a program that if you are having trouble, or drinking, or feel unsafe, you can go to the local police station and they can help you connect with resources, without having any consequence of getting in trouble with the law. So, I thought that was kind of a neat thing as well.
Dr. Jeffrey Guina (35:28):
It's really amazing. There are so many resources out there. Government resources, nonprofit resources, hospitals, clinics. It's just, sometimes people are like-
Dr. Ahsa Shajahan (35:42):
It's so hard to get in. It's so hard to get in. You call these numbers, a lot of times they don't work, or they don't take your insurance. And it's, for people that are not maybe like on the fence of trying to get help, it's really hard to get the right resources and to be able for it to work for you. So, I feel for people that are trying to get help, because sometimes it just seems like a lot of doors are closed. And then when doors are closed, you just go back to drinking.
Dr. Jeffrey Guina (36:07):
Right. And, this is the hard part. There's so many resources out there. A lot of times people don't know about them. Or the ones they know about, or the first few they try have huge wait lists or you can't get in, or they don't qualify. The other resource people can go to is, every county in the whole United States has a community mental health, public mental health system. And so in Oakland county, for example, it's OCHN. It's Oakland Community Health Network. And going to their website or calling, they can refer, depending on what you're looking for, to different places. And, then a lot of times they don't provide services themselves, but they will help be the ...
Dr. Ahsa Shajahan (36:57):
Navigators.
Dr. Jeffrey Guina (36:58):
Yeah. And help direct people to nonprofits like Easter Seals that see everybody, regardless of their ability to pay. So, whether someone has insurance, Medicaid, Medicare, or uninsured, there are organizations out there to help people.
Dr. Ahsa Shajahan (37:15):
Wonderful.
Dr. Jeffrey Guina (37:15):
And, I know I talked about 12 steps earlier, but I should note. AA, the 12-step programs are free, and studies show that 90 meetings in 90 days is just as effective to going to a residential rehabilitation center. So, one costs money and one's free, and you can do it on your own time. So it's something to consider.
Dr. Ahsa Shajahan (37:42):
Well, thank you so much for sharing your expertise with us and thank you for all that you do. I know, especially with the pandemic, psychiatric care is very difficult. And thank you for your service, and for your ability to be there for patients. And, thanks for being with us today.
Dr. Jeffrey Guina (37:59):
Thank you.
Dr. Ahsa Shajahan (38:00):
Thank you guys so much for being with us today. And, it was such a heartbreaking conversation, and great resources and advice that you've gave, Dr. Guina. And Jean, for your personal story, thank you so much for sharing that with us.
We leave you today with this healthy thought. During the pandemic, so many people have been picking up really bad coping mechanisms. And what it is, is we're all hurting. We're all having a difficult time through this pandemic, whether it be through actually getting COVID, losing people through COVID, really being stuck at home, not being able to do the things that we've always wanted to do and imagine ourselves doing. We're just in a tough spot, and everyone's struggling in their own way. And with the uptick of people drinking alcohol, we see it as such a huge problem, not only for our mental health, but our physical health. And we really just want to help you out today.
If you or your loved one is struggling with alcohol consumption, there is help out there. And as Jean said, it all starts with just the first step. You can beat this illness and the stigma around it by putting yourself first. Help is out there.
Speaker 1 (39:13):
Continue your journey to living a smarter, healthier life. Visit beaumont.org/podcast to access information and resources related to today's podcast.